title: Persistent benign paroxysmal positional vertigo: our experience and proposal for an alternative treatment.
abstract: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Despite the great efficacy of canalith repositioning procedures (CRPs), BPPV may persist (PBPPV). The aim of the study was to evaluate whether a prolonged and self-assessed temporal bone vibration (TBV) could change the outcome of PBPPV after 12 months of repeated treatments, in order to avoid further invasive and/or drug therapies. This evaluation was also conducted with respect to the entire BPPV population treated with CRPs. Seventy-two patients affected by PBPPV were enrolled in the study: 51 and 21 of them suffering from posterior semicircular canal (PSC) and lateral semicircular canal (LSC), respectively. PBPPV patients underwent a twice-a-day self-assessed TBV, using a common low-intensity massaging cushion. Patients were re-tested 1 week later and they were considered free from disease as the results of the positioning tests continued to be negative after 1 month. 70.6 % of PSC PBPPV and 61.9 % of LSC PBPPV patients had positive and statistically significant (P < 0.01) outcomes not biased by "age" and "gender" variables. The recurrence rate of BPPV (RBPPV) was also studied in the BPPV and PBPPV groups after a 12/24-month follow-up and any statistically significant result was found in multiple regression analysis between nuisance variables and RBPPV patients previously treated by CRPs or TBV. The present study suggests that the self-assessed and prolonged TBV could be an alternative treatment in patients affected by PBPPV otherwise addressed to undergo more invasive procedures and pharmacological treatment that are not completely side effects free.
authors.affiliation: Medical Science and Translational Medicine Department, "Tor Vergata" University, Viale Oxford, 81, 00133 Rome, Italy. ldcittadino@gmail.com
authors.forename: Marco
authors.initials: M
authors.lastname: Alessandrini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Micarelli
authors.forename: Isabella
authors.initials: I
authors.lastname: Pavone
authors.forename: Andrea
authors.initials: A
authors.lastname: Viziano
authors.forename: Domenico
authors.initials: D
authors.lastname: Micarelli
authors.forename: Ernesto
authors.initials: E
authors.lastname: Bruno
mesh_terms: D065635:Benign Paroxysmal Positional Vertigo; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012044:Regression Analysis; D013701:Temporal Bone; D016896:Treatment Outcome; D014717:Vertigo / Q000534:rehabilitation*; D014732:Vibration / Q000627:therapeutic use*